| NPI | 1972557890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: FL ME51624) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: LA 017322) |
| 207N00000X Dermatology (Licence: MN 28877) | |
| 207N00000X Dermatology (Licence: AZ 21961) | |
| 207N00000X Dermatology (Licence: TX K6231) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: NC 2013-02379) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: SC 36240) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: FL 51624) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: GA 042694) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2023-03-23 |